Saturday, October 25, 2008

Why Placebos Work

image by blary54,

It Is Faith, That's Why

Online medical blogs and news journals are agog with the latest piece of news about a survey conducted by the NIH to measure physician behavior and attitude concerning the use of placebo treatments.

image by srbichara,

Conducted amongst practicing internists and rheumatologists across the USA, the survey sought to find out whether doctors would baulk at prescribing placebos in place of actual medicines. Of the 679 physicians who responded, more than half said they regularly prescribed placebo treatments. The medicines which would be passed off as genuine treatment could be as bland as analgesics, as plain-vanilla as vitamins, or as insipid as pure sugar, while the fees would be collected without blinking the eye. Most of them (62%) acknowledged having no qualms about doing so. No moral, ethical dilemma for me here, no.

image by yenhoon,

This survey reinforces an earlier survey conducted in Jerusalem in 2004, where doctors from hospitals and family clinics participated. The outcome then too was roughly more or less the same: that doctors believe "benefits derive from positive patient expectations, and not from the physiological mechanism of the treatment itself." Ergo, the next time you go visit your doctor and buy the medicines they have prescribed, is quite possible that what you paid for and are swallowing with a gulp of water might be sugar that was already there in the jar in the kitchen.

image by jadegordon,

Reactions from colleagues in the medical fraternity have ranged from downright disbelief ("the survey respondents must be practitioners of alternative medicine") to moral outrage ("it's a disturbing finding"). Both reactions are not justified, as is the largely incomplete survey: in the fitness of things, it would help to also find out the impact of placebo treatment on the patients - did they at all get well at the end of it? If their condition improved and they became well, then why not, what's wrong with the placebo treatment? Isn't that what the Hippocratic oath tells us we should do - make them well? Then why the fuss?
image by barky,

We all know it by experience. If somebody makes up their mind to get well and overcome any amount of adversity, then focusing on just that one single thought is enough to see them through. I have seen it with my own eyes, these otherwise very ordinary people coming out of the most debilitating disease. And I am sure you must have heard about them from your social network too, if not experienced it firsthand. We always tend to file such incidents under the heading of "miracle", but come to think of it, there is nothing miraculous or incredible about these incidents: it is the power of thought and the feeling of faith that is behind them all.

Sanctuary of Our Lady of Lourdes, taken from St. Michael's Gate, wiki_*

* Sanctuary of Our Lady of Lourdes, Lourdes, France, wiki. Besides other religious material, this complex also houses a few taps that dispense "Lourdes water". Ask any scientist, and they will say it is plain water. But ask the person who has traveled for thousands of kilometers to drink the water flowing from these taps. They will say it has healing power. And very interestingly, the deeper and stronger the faith, the greater are the chances that they will return healed! So why do we pooh-pooh or undervalue the placebo effect?

And when somebody makes up their mind to be not well, then whatever be the quality of treatment given to them, you know as well as I do that they will not get well. We say that they have "lost the will" to live, and sure enough, the life is lost. It is the power of the thought in play: "thought" doesn't have a "mind" of its own. It does not judge what is "good" or "bad" - if you hold a particular thought in your mind and focus on it, its practical manifestation will occur in your life.

Nirguna Padukas at Ganagapur, Maharashtra, India_*

* Nirguna Padukas at Ganagapur, Maharashtra, India, courtesy Thousands of devotees throng this temple every day, many of them return home with jarfuls of sacred ash they dispense here. The ashes are supposed to heal the most incurable diseases. The most rigorous of scientific analysis, the strongest rationalization surrenders before the placebo effect - the power of the thought.

This is why placebos work. It is the unshakeable faith in the doctor one is visiting when not well, and it is the blind faith in the elaborate medical system which does the trick. And doctors know this.

Just one word here. Go easy on this placebo treatment thing, folks. Don't use it as an excuse to spare yourself the intellectual effort required to search for the latest treatment available in the medical knowledgebase and which you have access to.

For more of these insights on the subject of the power of thought, visit:

Yarrow flower, wiki
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Saturday, October 18, 2008

Remain Alert Of Your Self-Worth Index At All Times

image by flaivoloka,

Let Circumstances Not Dictate Your Sense Of What You Are

It is a known fact of life - our own sense of self-worth moulds and shapes not only our body, but also our destiny and future path. If we feel good about ourselves and about the world around us, this feeling percolates to every sphere of our existence. Our health barometer shows a good reading, our relationship barometer shows a good reading, and everything appears achievable and attainable. Yes, even in such turbulent economic times that the world is going through, circa 2008, we know in our heart of hearts that we will pull through.

image by code1name,

But the moment the self-worth index takes a dip, everything plunges. Something changes in our brain and body chemistry. An altogether different set of chemicals starts getting secreted. And the outcome is that we crave food - or we begin to hate food - and in general, start feeling depressed. A chain of events cascades, pulling further down the self-worth index. Things go out of control. The result? A host of diseases. And then we end up taking medicines that are aimed at neutralizing the chemicals, but not at solving the base, the core problem: Shoring up the self-worth.

image by thanx,

As human beings, we naturally tend to equate our self-worth with our achievements. So when we get a promotion or buy a new vehicle, we feel worthy. Or if we fall in love and the other party says yes, we feel good for ourselves. Think of any of the nicest things that can happen, and just watch the sense of self-worth zoom! But when the reverse occurs? The blues take over.

image by auroqueiro,

This equating one's sense of self-worth with one's achievements is perhaps part-DNA, but definitely something that we imbibe from the environment as part of the growing-up process. The uncle who puts the gun to his temple because his business got wrecked, or the sister who goes and hangs herself to the ceiling fan because her lover ditched her, or the father who takes to drinking because he lost his long-held job, or the mother who becomes depressed and bed-ridden because she lost hers, ... are sad incidents, but are definitely not good role-models for the vulnerable psyche of a growing child. In the face of such crises in their life, instead of caving in, when they bravely endure and overcome their particular situation, then that would be a way of living that the child can take forth further.

image by yoshiaka,

The business got wrecked? Fine, work on it, build another one. The lover ditched? So what, he or she didn't deserve you in the first place! There is somebody else out there who is more deserving, go look. A long-held job got taken away? Oh, then this is the right time to rethink one's vocation and station in life. There is no dearth of what can be done in this world. The Universe is benign, and all we have to do is to be optimistic, hopeful, cheerful --- and persevere.

image by pkmahanand,

The message that the child would then learn, and this is something that we should be aware of at all times - is that our self-worth is not defined by our circumstances. Circumstances come, and circumstances go. This is the yo-yo of life. Nobody has escaped the yo-yo, neither the kings, nor the hermits. But what is in our control and in our hands is to remain alert and be always aware of our sense of self-worth. And not let some silly situation we might be going through dictate its value.

image by a-bollen,
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Friday, October 10, 2008

Keeping The Mind Healthy

image by prepaan,

As The Storm Of Gloom & Doom Swirls Around Us

As the WHO observes today (10 October) as World Mental Health Day, never before was the need so acutely felt for mechanisms that can be taken recourse to, to keep in good health the minds of the individual and the community.

image by shiyali,

Whether it is Los Angeles or Ludhiana, Boston or Bangalore, people from all walks of life are facing the flames of the economic recession that it is now officially confirmed we are going through. And world over, stress and anxiety levels are rising. If there were a stress -meter installed somewhere, it would show readings at a high perhaps never before experienced in this past decade!

image by stigespen,

The problem is, stress and anxiety are just the first step that otherwise perfectly okay individuals take towards descent to a full-blown mental health condition, and very surprisingly, we don't seem to realize this simple fact. The subsequent steps can be any of the myriad pathways that can lead to any of the manifestations of the condition.

image by revati_me,

Stress levels don't need any invitation to rise. We don't become stressed only when something happens to us personally. It is contagious, so when we read about a family-head shooting everybody in his household before turning the gun to his own temple, or when we read about some 90-year-old grandma shooting herself in the shoulder because the police came to serve her eviction notice on grounds of foreclosure --- we cannot help empathizing with the victims somewhere deep inside, and that is when stress walks in the front door and holding our hand in its hand, takes us gently towards the descent. The turbid thoughts begin to have a direct impact on our blood pressure, and from there on, manifests at the somatic, the body level. That vague feeling of fatigue? That irritability that doesn't seem to go away? The feeling of being on the edge? The loss in sleep? We gradually begin to be enveloped in the cocoon of some disorder that is ultimately our own creation. Happily, we can tear away this cocoon very easily, and all it takes is a gentle sweep.

image by tata,

In such times of doom and gloom, actually in especially such times, it is of utmost importance that we be aware and alert of the nature and quality of thoughts going through our mind. For our own sake, and for the sake of the people who depend on us, we have to keep our mind firmly rooted in the positive. Instead of dwelling on the worrisome and the hardship and the dreadful, let's dwell on the delightful reassurance that this is a passing phase that every generation has to go through at some time or the other and that we are no exception; let's focus cheerfully on ways to overcome the hardship -- when one door closes, others open, you just have to persevere and keep looking; let's have optimistic faith that there is a higher force that we never have and never will fathom, and which is guiding us through thick and thin.

image by shiyali,

This is not escapism. Not some wishy-washy namby-pamby mawkish sermon either. We are taking lessons in the science of happiness for our own benefit. For while there are certain things - lots of things actually - in this world that are beyond are our control, how we respond to them definitely is. Within our control, that is.

image by nkzs,
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Friday, October 03, 2008

The Cost Of Anger

'The Great Day of His Wrath' - John Martin_*

* 'The Great Day Of His Wrath' - John Martin, wiki.

It Is A Heavy Price To Pay

It used to be not an uncommon sight in the office next door to mine. Employees would stop breathing, at the sight of the signs that clearly foretold that the volcano was about to erupt. And the signs never let anyone down; when the volcano erupted, the lava submerged the entire office. After it subsided, it would be my turn to wait. For the much-relieved-after-the-episode boss would walk into my office for a bite of sandwich washed with a cup of coffee. The eruption would create a void in the stomach which had to be filled urgently, you see.

image by cieleke,

Anger, and uncontrolled anger at that, has gone down in history as the one of the most damaging of all emotions. It is the 'dispositional' form of anger that one is talking about here, the one that has got nothing to do with self-preservation or reacting to perceived-injustice, but has everything to do with churlishness and instinctive-irritability.

image by simeon,

The boss who is not mature enough to handle their anger and explodes when an employee does some mistake - grave or trivial - perhaps does more harm to the company than the mistake itself. For, while the boss may even forget the episode after the bout of anger has subsided - as would be the case with my next-door neighbor -, the episode creates a ball of negative emotions that does not dissipate into thin air. Swallowed by the employee, the ball triggers a counter-reaction in their mind. And they usually do not, cannot exercise the same freedom and privilege to explode back. This implies that the counter-reaction does not find an appropriate outlet for self-expression.

image by doortenj,

But find an outlet it has to. So the anger is taken out on the kids or the spouse at home - well, wherever there is a victim that is usually in subjugated mode in their relationship. Alternatively, the person slides into a passive-aggressive behavior that stems partly from self-hatred at one's powerlessness to break free from such oppressive condition - alternative jobs are not like fruit that somebody can go pluck from an overladen tree in somebody's orchard -, and partly from a slyness that wants to get even with the perpetrator, someday, somehow.

image by spekulator,

In the case of my neighboring office, I saw the anger being vented in both these ways. One employee in that office a colleague of mine personally knew would regularly bash his kids in the evening, without justification, whenever he became the butt of anger during the day time in the office. In fact, it became standard practice for this colleague to ring up the employee's wife and forewarn her, so that the wife could hide the kids out of sight well in time.

In another case, a once-top-performing employee of that office began making mistakes that would have been considered unthinkable coming from her. Eventually a time came when she quit, without notice. She was indispensable to the company's operations, so goes without saying that her absence degraded the outfit's business significantly. Later, everyone could pinpoint the exact occasion when the slide started: a sensitive soul, she was insulted in front of her peers and juniors by an insensitive boss who at the very least should have taken lessons in both anger and personnel management, before launching the business.

image by weirdvis,

With time, I relocated my office premises, and after moving out of the city, I gradually got out of touch with my friend, the boss. Yesterday night, an ex-employee who was with me in that same office premises rang up to inform that the boss had died. Cardiac arrest. He was in one of his "volcano-eruption" sessions when it happened. One of his arteries must have most likely busted. The same set of employees who he was spewing the lava on, bundled him into an ambulance and took him to the hospital, in the hope that he recovered so that he could continue with the spewing. Uh, resume from where he had left. But that was not to happen. He was declared dead on arrival.

image by mapelc,

Otherwise a warm and generous human being and a good friend, one who would often go out of his way to help people in times of need, this man's inability to take control over his temper overshadowed all his good traits. To the extent that, in his lifetime, he inadvertently made more enemies than he consciously made friends.

image by bjearwicke,

Anger. You pay a heavy price when you come under its control.

image by some_bo,
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